Hello. Mr. XXXXXXX

According to you there is viral fever from one month off & on.
In your query there is no malaria and typhoid fever.
One month back you were suffering from fever, than 15 days back admitted in hospital for 4 days.
Now again from last 4 days there is evening rise of temperature.
Actually in all these days you were in fever but low grade,so unnoticed.
In this type of situation the causes of fever may be numerous but most probable cause are as,
1 Typhoid fever ( during the early days of typhoid the Widal test may be negative)
Nonspecific symptoms of typhoid fever are Fever ( low or high grade)
Sore throat & cough (mild degree as you were in dilemma that it is due viral in the first stage, one month back)
Abdominal pain (mild)
Rash (disappear within first five days so unnoticed)
2 Tuberculosis, early in the course of disease symptoms & sign are non-specific & very slow as fever , night sweats, general weakness, loss of appetite. Cough and expectoration are late symptoms in few cases.
3 Heat stroke mild degree due to exhaustion.
4. There could be some unexplained causes which needs a physical examination along with tests to prove. I still feel that you need re-evaluation of the cause of the low grade fever. Sometimes it could be medicine induced too. Please consult a XXXXXXX Medicine physician and evaluate.

Hope I have answered your query. If any further question I will be happy to help.
Wish you good luck.
Dr. HET

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Hello,

Thanks once again for asking this question.

Viral infection is most often a self resolving condition. Therefore we seldom test for virus in clinical practice. However if viral symptoms persist or if complications develop, serology and viral isolation in tissue culture are considered for important viruses. These tests are done by pathologists.

The most advance tests now a days are measurement of the amount of viral RNA & DNA in peripheral blood. The test are again done only when we suspect serious viral infection.

Your platelet count was normal after treatment. This is a positive sign.

Typhi "O" and Typhi "H" titres are 1:160. This suggest possible typhoid fever. However we need to observe rising titres to confirm typhoid infection. Therefore I suggest you to follow up with your treating doctor if fever persist. He/she can get another Widal test done to confirm typhoid and treat it accordingly.

Hope I have answered your query up to your satisfaction. If any further question I will be very happy to help.

Good luck.
Dr. HET

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